Superior mesenteric artery syndrome

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The superior mesenteric artery syndrome is a separate form of partial duodenal obstruction in which the caudal third of the duodenum is compressed between the superior mesenteric artery and the aorta. Compression occurs in excessive lordosis (in patients on a plaster bed after spinal surgery) and in the loss of intra-abdominal fat, which keeps the duodenum in position.

  • chronic duodenal obstruction, chronic duodenal ileus , plaster bed syndrome;
  • affects lean girls more - repeated vomiting after eating and abdominal pain;
  • diagnosis - contrast X-ray (extension of the duodenum with rapid peristaltic and antiperistaltic waves);
  • therapy - alleviation - the position of a praying monk (crouched position on the knees) is recommended after a meal;
    • sometimes nutrition by nasojejunal tube or parenterally is necessary - fat gains when weight increases;
    • possibly surgery.

400px|thumb|Břišní cévy

Superior mesenteric artery

The superior a. mesenterica (about 2 cm caudally from the coeliac truncus behind the head of the pancreas, level L1) is the main branch for the duodenum (aa. pancreaticoduodenales inferiores), jejunum (aa. jejunales), ileum (aa. ileales), caecum (a. ileocolica), colon ascendens and colon transversum (a. colica dextra) up to the Cannon-Böhm point (about 2/3 colon transversum). Outside of the small intestine, appendix and large intestine, a. mesenterica sup. is also involved in the supply of the head of the pancreas, it can also transmit branches to the stomach and in up to 30% of cases even an additional a. hepatica accessoria.

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